Onicomicoses e a terapia fotodinâmica

Abstract

Onychomycosis is the most common nail disease that affects 10% of the world population. Its prevalence has been increasing around the world due to the increase in the elderly population and the number of immunosuppressed. It is a disease that causes emotional, social, occupational and physical effects. Cause constraints of workplace and social and discomfort when walking and pain when toenails are affected. The fungi dermatophytes, yeasts and filamentous non-dermatophyte fungi are the main agents of onychopathies. According to the clinical presentation of onychomycosis (location, extent and color), these can be classified into distal subungual, proximal subungual, white superficial and full onychodystrophy. The treatments are topical, oral or associated but onychomycosis are a therapeutic challenge, and is considered the surface ringworm treatment more difficult. Many patients do not properly adhere to treatment due to the long time, price of drugs, gastrointestinal effects, toxicity, inefficiency and relapses. Oral antifungal have hepatic and renal adverse effects, drug interactions affecting special populations such as patients with systemic diseases, children and the elderly. Due to the limitations of treatments for onychomycosis, some studies have shown the use of photodynamic therapy with promising results. This is a therapy with proven efficacy in several types of cancer, dermatological treatments and to fight viruses, bacteria and fungi. Among the benefits are the shorter treatment time, low occurrence of local adverse effects, no systemic adverse effects, high patient compliance, selectivity by fungi, absence of fungal resistance.